임산부의 체질량지수에 따라 산전 부신피질호르몬 치료가 신생아 호흡곤란증후군의 발생에 미치는 영향 = The Effect of Antenatal Corticosteroid on Incidence of Respiratory Distress Syndrome According to Maternal Body Mass Index임산부의 체질량지수에 따라 산전 부신피질호르몬 치료가 신생아 호흡곤란증후군의 발생에 미치는 영향

다국어 초록 (Multilingual Abstract)

Objective To investigate the effects of antenatal corticosteroid (ACS) on incidence of neonatal respiratory distress syndrome (RDS) according to maternal body mass index (BMI). Methods We retrospectively reviewed the medical records of 715 singleton pregnant women who delivered between 24+0 and 34+0 weeks of gestation, from January 1996 to December 2006. Subjects were categorized into three groups according to ACS exposure a nonuser group (n = 244), a single-course group (n = 377) and a multiple-course group (n = 94). Subjects were re-categorized into three groups according to maternal BMI at admission group 1 (BMI < 23.0 kg/m2, n = 234), group 2 (BMI 23.0-24.9 kg/m2, n = 166) and group 3 (BMI ≥ 25.0 kg/m2, n = 315). Univariate and multiple logistic regression analyses were used for the statistical analysis. Results Overall, the incidence of RDS was significantly lower in ACS-user groups than the non-user group, with lowest incidence in the multiple-course group (non-user vs. single-course vs. multiple-course 44.3% vs. 41.1% vs. 11.7%, P < 0.001). The incidence of RDS was not different among the three BMI groups. Multiple logistic regression analysis showed that single- and multiple-course of ACS was significantly associated with reduced incidence of RDS single-course, odds ratio (OR) 0.593, 95% confidence interval (CI) 0.373, 0.942; multiple-course, OR 0.085, 95% CI 0.034, 0.213. However, maternal BMI was not associated with reduced incidence of RDS with different ACS-courses ( P for interaction = 0.690). Conclusion ACS therapy, especially when multiple-course was used, was significantly associated with reduced incidence of RDS, but maternal BMI did not influence its effectiveness.